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Doctors' Diaries

The Hippocratic Oath Today:
Non-Doctors' Responses

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I like the thought already expressed by one doctor "Do unto others as you would have them do unto you." That really gets to the heart of the matter and addresses the fact that there will always be a difference of opinion as to the "sanctity" of human life. As a society we should accommodate both points of view, acknowledging that individuals have a right to determine whether they wish to live or die, and that doctors who share that belief be allowed to meet their needs without social or legal penalty.

Much of the dialogue on abortion, euthanasia and patient/doctor rights seems driven by quasi-religious considerations and a mindset that places humankind at the pinnacle of evolution. However, I believe we are gradually moving towards a more balanced perspective and reluctantly waking up to the need to conserve resources and make radical adjustments if we are to avoid gross overpopulation and global suffering.

Throw out the cant and hypocrisy of the old oath and even the erudite "modern version." I vote for "Do unto others as you would have them do unto you!"
Michael Jones

From my perspective as a student of history, some elements of the medical profession appear to be evolving in directions that compromise the original spirit and intent of the Hippocratic Oath. Rather than see that happen, and see doctors increasingly under pressure to compromise one set of values for another, I would make this proposition:

We need a separate career field whose emphasis is not on the preservation of life but rather the humane assistance of its closure, whether that be naturally occurring or artificially induced. These would be individuals not under the Hippocratic Oath but under a totally different oath, equally committed to the sanctity of humanity and the diversity of religious belief.

Just as there is a fine separation between doctors who prescribe medication and those pharmacists who dispense it, there needs to be separate practice in which the professional would not be under pressure to compromise his or her commitment to the preservation of health and well-being. Individuals involved with hospice already do this to some degree; they just need to be given more professional jurisdiction. All doctors know when they have reached the limit of their specialty, and when the time comes to make a referral to another specialty. Let's stop forcing our doctors to do something they were never intended to do.
Robert Williams
Southern Oregon University

I saw your Web site feature in regards to the Hippocratic Oath. However, you failed to mention the Osteopathic Oath. Do you not know that we are full physicians who do surgery, prescribe drugs, and exist in all specialties? M.D.'s are not the only physicians in America. Enclosed I have copied the Oath. Perhaps you will see fit to incorporate us into your feature. Please do not neglect us. We have a long and proud history.

The Osteopathic Physician's Oath
I do hereby affirm my loyalty to the profession I am about to enter. I will be mindful always of my great responsibility to preserve the health and the life of my patients, to retain their confidence and respect both as a physician and a friend who will guard their secrets with scrupulous honor and fidelity, to perform faithfully my professional duties, to employ only those recognized methods of treatment consistent with good judgment and with my skill and ability, keeping in mind always nature's laws and the body's inherent capacity for recovery.

I will be ever vigilant in aiding the general welfare of the community, sustaining its laws and institutions, not engaging in those practices that will in any way bring shame or discredit upon myself or my profession. I will give no drugs for deadly purposes to any person, though it be asked of me.

I will endeavor to work in accord with my colleagues in a spirit of progressive cooperation, and never by word or by act cast imputations upon them or their rightful practices.

I will look with respect and esteem upon all those who have taught me my art. To my college I will be loyal and strive always for its best interests and for the interests of the students who will come after me. I will be ever alert to further the application of basic biologic truths to the healing arts and to develop the principles of osteopathy that were first enunciated by Andrew Taylor Still.

Thank you for your time.
Anonymous

I highly recommend leaving the modern oath exactly as it is. The modern Hippocratic Oath should be a powerful Mission Statement. It should not be a platform of ancient and modern medical and social issues. Leaving the modern Hippocratic Oath as a Mission Statement reminds the doctor exactly why s/he became a doctor, and the good doctor affirms this why verbally and in writing, and more importantly, this why becomes a Form, an Idea in his/her mind while living. Commenting further on medical and social issues, both ancient and modern, such can be addressed in Purpose and Action documents, which "reside" under the Mission Statement, and such P&A documents can be changed to suit the reality of the times.
Roland J. Stoller

I am a retired Aerospace Science Education Specialist. While in college I majored in biology and toyed with the idea if attending medical school.

The classical oath makes reference to pagan gods. Since paganism was popular at this time, it was acceptable then but unacceptable now. Most doctors today may have some religious persuasion, and it is likely that they will recognize and may even worship the God of most of the God-worshipping population of the world. This is the God to be mentioned in the oath, if God is to be mentioned at all. After all, an oath is calling God to witness someone accepting the conditions of the oath.

The classical oath burdens, unnecessarily, the new physician to be responsible to his or her teacher to train certain relatives of the teacher, and his or her own relatives, to teach the healing art. Today there is so much illicit sex (homosexual and heterosexual) prevailing that it would be worth adding this as a restriction in the modern oath.

As far as I can understand in reading both oaths, there does not seem to be any contradiction in what the oaths propose. The problem arises when we realize what doctors can do to, and for, patients that are beyond the parameters of either oath. Though abortion is still an undesirable availability in the sight of many, it is legal and desirable by perhaps just as many. Unless Roe v. Wade is repealed in the U.S., a universal oath should bypass this issue and leave it out since it is likely to prevail in other parts of the world. If it is defeated in the U.S., then the American Hippocratic Oath should specifically recommend against abortion.

Otherwise, I see the modern oath as adequate. It is the responsibility of the individual doctors to have the moral and ethical values to decide if and how far they are willing to go beyond the guides of the Hippocratic Oath.
Ransom Ritter

I have been following a friend through her medical treatment for several years now. I have seen doctors who seem to be more interested in making money than following the Hippocratic Oath, either the original or modern one. They claim they will treat the poor but withhold medicine that may cure the patient in order to get more money out of the patient's insurance, Medicare or Medicaid. The specialist refuses to see patients without the right insurance, although patients may really be benefited by the doctor's knowledge of their condition.

These doctors are more interested in giving less care, less expensive treatment, or not admitting a person to the hospital, though that person clearly would not have stayed in the emergency room for hours if they did not need care.

On the other hand, some doctors do medical tests that seem excessive on people with high-paying insurance. People who live in affluent areas are sent to specialists to rule out illnesses that there is only a small chance they have. Some medical facilities pad the bills to the insurance companies by charging extra for a treatment that may not have been done.

I know in every field there are people who abuse their positions. However, in medicine, these doctors were supposed to have taken an oath. Does the oath mean something to these doctors after they have been practicing awhile?
Francis O'Reilly

Having worked in the lower levels of health care, I've worked under numerous doctors and nurses. The implication of the Hippocratic Oath is that there is little variation among health-care professionals. I think it would be more useful if consumers were informed of the capabilities of the doctors and others, including chiropractors and hospitals, that they have to rely on. Of these others no oath is required, and yet they are often as much or more involved in a patient's care and treatment. Without the oath, there would be little difference in the responsibility that would fall on each of these caregivers.

Another point is the worsening of health care availability, especially for those of us who can no longer afford it. A few decades ago it cost only a few dollars a month and included anything from a doctor's visit to an involved surgery. Now it is a hundred times more expensive just to get in the door. This makes a joke of the Oath's ideal of treatment without regard for the bill at the end.
David Hulme

I must admit I had never read either the classical or the modern version of the Hippocratic Oath. I had always assumed there was only one, and I falsely thought all doctors had to take it. I think it's clear that the classical version is completely out of touch with reality, and I wonder if it was ever taken seriously even back in Hippocrates' era. The modern version tries to help put a little more reality into the oath and adds a moral element and a more humanistic approach to the document. It tries to deliver a physician we all can respect. I think it comes down to respect—on both sides of the table.

Far too many of today's doctors have little or no respect for the importance of the patient-to-physician relationship. Instead of promoting this most critical part of health care, doctors are taught by their lawyers' insurance companies, and their own peers to turn a deaf ear to their patients and believe only test results. Relationships take time, and time is the enemy. In this environment, listening and observing become counterproductive.

We as patients tolerate physicians who do not care, prescribe inappropriate tests and medicines, and act in a condescending manner. We have little respect for them but we feel powerless.

I think if all doctors had to recite this (modern version) Oath, display it on the office wall and retake it every few years, it would go a long way toward rebuilding some of the lost respect.
R.J. Francis

I believe the original, ancient oath contained valuable moral and ethical constraints and imperatives that are essential for those serving fellow men (and women). A covenant philosophy is still needed to ensure unbiased and ethical behavior in those who command the great respect and responsibility that physicians have in our society. Furthermore, accountability and consequences for breaking the societal covenant should be reinstituted and monitored by physicians and nonphysicians alike. Perhaps this is idealistic; however, patients need this assurance for their confidence and reliance on physicians to be sustained untainted by fear and distrust. If these are lost, individual and public health will suffer—perhaps with catastrophic results.
Anonymous

Today's modern medical technology produces smarter, knowledgeable doctors—and that's it. I don't think it transformed them into healers; they're just there to introduce at bedside the cure. Most of today's doctors are there just for the big bucks. I think the true healers are the caregivers with true and compassionate tasks as health-care workers.
Anonymous

With regard to "doing no harm," perhaps the profession should take a look at its own practice of harming graduating students by imposing working hours of internship and residencies that severely damage the new doctor's physical, mental, social, spiritual, and in some cases marital health. Shame!
Anonymous

Read the Oaths The Hippocratic Oath: classical version
The Hippocratic Oath: modern version
Comments on the Oaths Doctors' Responses




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